NPI | 1649847617 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | Yes |
Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: FL PA9114139) |
Additional Taxonomies | 363A00000X Physician Assistant |
Enumeration Date | 2021-06-08 |
Last Update Date | 2022-09-19 |